As we slowly stumble out of this pandemic, we are entering a new age of lessons learnt than we never experienced before. It is important to register the fact that human trauma is something we bring with us as we re-set our lives while carrying that stress forward back to society.
Human trauma remains dormant and hidden
Many people are in the process of healing and recovery while some are dealing with extreme traumatic stress disorder. On the inside, things might not be very calm and stable. Taking note of this phenomenon may take time, as most of the trauma remains dormant and hidden. human trauma
As a civil society, it is important to take charge of the situations around us as we venture out carefully. The pandemic is not over yet but the world must learn to adapt and economies must re-start. People have little understanding about traumatic stress- what it is and what follows. Post traumatic stress disorder is ignored as a serious ailment in some parts of the world where the knowledge on treatment is limited.
Most countries have reported a severe degree of mental health disorders that are not reported. Unless we do not take care of our own emotional health, we cannot help others. We need to analyze the triggers and manage them earlier before the actual impacts kick in- like a deadly drug with no cure.
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Human Trauma and Stress
In Pakistan, over 75% of the population suffers from mental health disorders and are never treated for the ailment. These people can be triggered negatively at any point in time, unless we are able to identify what triggers the stress. People we meet may often be dealing with painful stress that goes unnoticed. The process of healing and recovery takes a while and we must demonstrate social empathy as we re-enter our lives after COVID-19.
The pressure, force or strain on the human mind and body from a major event that may have led to shock is called “Traumatic Stress.” Learning about human stressors experienced by others can also lead to a traumatizing experience.
In usual situations, the victims develop fear and anxiety and a fear for their lives, when confronted with a serious injury. In some cases, the individuals dissociate, become defensive or may even become point-blank rude due to numbing or defensive avoidance. Such scenarios are common where the intense response to the stressor may not occur immediately after the incident has terminated until a considerable time has passed.
Some of the common examples of Traumatic faced during COVID19 include: unexpected death of a family member or loved one, observing an unnatural death of another person, man-made natural disasters, road accidents, casualties of war, life threatening medical conditions, interpersonal violence including sexual abuse, domestic violence, child abuse and other criminal abuses.
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Post Traumatic Stress Disorder human trauma
Some people develop post-traumatic stress disorder or PTSD, depending on the nature of the trauma. Here in Pakistan, we have problems like poverty, population and polarization-all of which lead to fear, numbness or disconnection where many people are unable to cope with the stress.
Individuals can be upset for several weeks in a row without identifiable reasons and may even recover without medication. But not everyone is mentally strong or stable to ensure recovery on their own. Depending on how serious the trauma exposure is around that person, PTSD can be a long term condition that can present severe consequences for the entire family and not just the individual victim or patient.
According to the latest US report by the National Center for PTSD, the lifetime prevalence rate in an adult American is estimated at 7.8% , where women are more likely to develop PTSD at 10.4% as compared to 5% in men. Not all people experiencing traumatic stress will develop this disorder. In less developed nations, the numbers are higher. Wherever there are higher number of cases of rape, childhood physical abuse, murder or conflict and war, the side effects have shown a higher level of trauma associated with mental health disorders.
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Response to Stress
No one person is alike therefore no one reacts in the same manner. Traumatic stress victims react in a variety of ways after an assault or an accident or a natural disaster. According to experts, many people develop ‘emotional’ responses to highly stressful experiences. They may include terror, shock, irritability, blame, anger, guilt, grief, sadness, helplessness, loss of pleasure and difficulty feeling happy.
Some people develop ‘cognitive’ responses to high mental stress where the symptoms are not physically identifiable in earlier stages. Symptoms like confusion, impaired concentration, memory impairment, self-blame, disbelief, nightmares, intrusive memories, decreased self esteem and impaired decision making ability are highly common as the effects go to the brain.
Traumatic stress affects our physical being. Here we see many habit changes that can be seen and highlighted quickly. Some of the common trigger signs include fatigue, insomnia, decreased appetite, headaches, decreased libido, reduced immune response, cardio-strain, gastrointestinal upset and increased physical pain.
While this is common, what we sometimes fail to predict are the common psychological interpersonal disorders, with a majority of people including males, females and children. We see the signs such as increased relational conflict, alienation, social withdrawal, impaired work performance, distrust, rejection, over-protectiveness and feelings of abandonment. We see the signs and we ignore them.
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Beyond the Ordinary
Sometimes, there are issues that require immediate and professional medical attention where the individual victim must never be ignored. Here, one must believe in the wisdom of a mental health professional. These are called ‘beyond the ordinary’ situations that may include:
Severe Dissociation; where the victim loses sense of identity /amnesia. Severe Intrusive Re-experiencing; where the victim experiences nightmares/flashbacks. Severe Avoidance; where the victim faces social or vocational withdrawal /agoraphobia. Severe Hyper-arousal; where the victim has panic episodes and violent impulses. Severe Anxiety; where victim is experiencing severe phobias, unshakeable obsessions, fear of losing control and paralyzing nervousness. Severe Psychotic symptoms; delusions, bizarre thoughts and hallucinations. Severe Depression; including worthlessness, self-blame, early awakenings, self-medication and substance abuse.
The key here is to understand the ‘type’ of stress, the ‘age’ of the person experiencing the stress, ‘education’ level, family ‘history’ of psychiatric disorder, ‘social support’ being received after the trauma and ‘personality traits’ like pessimism, hypersensitivity and other negative reactions.
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Acute Stress Disorders
In case of a sudden life threatening incident or a sudden uncontrollable frightening experience such as sexual assault, motor accident, fire, receiving serious news on a life threatening diagnosis or facing extreme domestic violent abuse, the person is left mentally damaged and psychologically scarred for a substantial period of life. These severe reactions are called Acute Stress Disorders or ASD’s. The good news is that ASD’s are severe disorders that may or may not last for very long, if proper treatment, care and empathy are provided to the sufferer.
Associated Illnesses
In addition to PTSD and ASD, people have experienced high levels of trauma that leads to psychiatric disorders. They are very common in our highly toxic societies where people do not have the basic amenities to lead peaceful and healthy lives and where living standards are poor and downgraded. They include: depression, drug-abuse, panic obsessive, compulsive disorder (OCD), sexual dysfunction, eating disorder, suicidal tendencies, hopelessness, anger, lack of trust, workaholic-ism, homelessness, inability to cry or show signs of emotion, alcoholism and betrayal.
Sometimes, the traits get ingrained in the personality and constantly interfere with the smooth functioning of an individual. Other people practice ‘ excessive avoidance’ and are in a state of constant denial by restricting their lifestyle to an extreme degree, maintaining no contact with ‘reminders’ of the human trauma and people associated with a troubled past and simply erase that part out of their lives. Such people then end up with lesser symptoms and are in more control of their stressors.
Ideally, most successfully treated patients find solace in immersing in a healthy work-life balance, by taking pride in their professional life and having a good family circle of positive relatives and friends who inspire. Here, long term positivity wins and reduces the re-emergence of trauma or acute stress symptoms.
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Burnout
The biggest challenge in a close-knit culture is that we live, thrive and face everything together. Sometimes, the helping professionals or helpers get impacted while working with the victims as different stressors manifest in the form of a cumulative psychological strain which is known as the ‘Burnout”.
This affects the healthy person who is not the patient. For example: doctors on duty are given weekly breaks or operate in shifts to avoid slow depression or exhaustive burnout over time. Many factors lead to a burnout situation within the family or community. This includes: longer work hours with fewer resources, lack of clarity on future success, emotional drain of empathy, professional isolation, non-reciprocated attentiveness and failure to live up to one’s own big expectations of self.
The identifiable impacts of burnout are visible if there is lots of boredom or discouragement around a person triggered by a general lack of empathy in the subconscious mind. During treatment of trauma, we often come across case scenarios where we see signs and symptoms of post-traumatic stress disorder in patients that mirror the symptoms earlier found in other friends or family members. These are signs of STS-secondary traumatic stress.
Compassion
As humans we all have a certain degree of empathy or caring in us called ‘Compassion’. There is a non-clinical compassionate way of helping a trauma patient. People who have such feelings are themselves victims of ‘compassion-stress”. It is a natural outcome of being in knowledge of the trauma being faced by the other person and holding onto it while associating with the victim- that can eventually lead a healthy person into isolation. Long term compassion stress leads to a state of dysfunction and physiological and emotional exhaustion termed as ‘compassion fatigue”.
Here is where we need to have ‘positivity in life”-a gift given to us by God Himself with the wisdom and sense to practice and preserve that gift in our daily lives. The true sense of compassion is ‘contentment’. The contentment is the essence of our personality that brings us closer to peace, relaxation and tranquility. This process can also be termed as ‘compassion-satisfaction’.
The success of the process through contentment comes from the effective development of the 5 senses such as: sense of strength, sense of confidence, sense of meaning, sense of spirituality and sense of resilience.
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Human trauma: What happens next?
As adults, we become caretakers. It is our duty to ensure safety and stability for our loved ones. In order to do that effectively, we must understand our own state of minds on ‘how much’ we can do for others. Be aware of this term called ‘Vicarious-traumatization’ – a state of permanent transformative change resulting from doing excessive therapeutic work with trauma survivors.
A healthy committed and dedicated helping human being can fall prey to this condition over a period of time which in-turn may affect: relationship with hope and meaningful life, unmet psychological needs, intelligence, willpower, sense of humor, ability to judge wisely, connection with others, sense of being grounded and the sense of self as viable, relevant and vital.
We must watch out for negative behavioral changes that lead to stress and human trauma and identify with the ‘5-senses’ that lead us to contentment and positivity.
Post COVID- 19, we are well-informed to overcome the odds.
The author is a Director at Children Nature Network Asia, writes on Global Affairs, Climate Change, Governance and Public Policy. Zeeshan is an Environmental Journalist & Change Maker, with over 20 years of expertise in Media, Education and Banking sectors. The views expressed in this article are the authors own and do not necessarily reflect the editorial policy of Global Village Space.